Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Vienna Clinical Trial Center, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Eye (Lond). 2024 Apr;38(5):863-870. doi: 10.1038/s41433-023-02793-5. Epub 2023 Oct 24.
BACKGROUND/OBJECTIVES: To analyse short-term changes of mean photoreceptor thickness (PRT) on the ETDRS-grid after vitrectomy and membrane peeling in patients with epiretinal membrane (ERM).
SUBJECTS/METHODS: Forty-eight patients with idiopathic ERM were included in this prospective study. Study examinations comprised best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) before surgery, 1 week (W1), 1 month (M1) and 3 months (M3) after surgery. Mean PRT was assessed using an automated algorithm and correlated with BCVA and central retinal thickness (CRT).
Regarding PRT changes of the study eye in comparison to baseline values, a significant decrease at W1 in the 1 mm, 3 mm and 6 mm area (all p-values < 0.001), at M1 (p = 0.009) and M3 (p = 0.019) in the central 1 mm area, a significant increase at M3 in the 6 mm area (p < 0.001), but no significant change at M1 in the 3 mm and 6 mm area and M3 in the 3 mm area (all p-values > 0.05) were observed. BCVA increased significantly from baseline to M3 (0.3LogMAR-0.15LogMAR, Snellen equivalent = 20/40-20/28 respectively; p < 0.001). There was no correlation between baseline PRT and BCVA at any visit after surgery, nor between PRT and BCVA at any visit (all p-values > 0.05). Decrease in PRT in the 1 mm (p < 0.001), 3 mm (p = 0.013) and 6 mm (p = 0.034) area after one week correlated with the increase in CRT (449.9 µm-462.2 µm).
Although the photoreceptor layer is morphologically affected by ERMs and after their surgical removal, it is not correlated to BCVA. Thus, patients with photoreceptor layer alterations due to ERM may still benefit from surgery and achieve good functional rehabilitation thereafter.
背景/目的：分析特发性视网膜内膜（ERM）患者玻璃体切除和膜剥除术后 ETDRS 网格上平均光感受器厚度（PRT）的短期变化。
受试者/方法：本前瞻性研究纳入了 48 名特发性 ERM 患者。研究检查包括手术前、术后 1 周（W1）、1 个月（M1）和 3 个月（M3）的最佳矫正视力（BCVA）和光学相干断层扫描（OCT）。使用自动算法评估平均 PRT，并与 BCVA 和中心视网膜厚度（CRT）相关联。
与基线值相比，研究眼的 PRT 变化在 W1 时，在 1mm、3mm 和 6mm 区域均显著降低（所有 p 值均<0.001），在 M1（p=0.009）和 M3（p=0.019）时中央 1mm 区域，在 M3 时 6mm 区域显著增加（p<0.001），但在 M1 时 3mm 和 6mm 区域以及 M3 时 3mm 区域无显著变化（所有 p 值均>0.05）。BCVA 从基线到 M3 显著增加（0.3LogMAR-0.15LogMAR，分别为 Snellen 等价物 20/40-20/28；p<0.001）。在术后任何一次就诊时，基线 PRT 与 BCVA 之间均无相关性，在术后任何一次就诊时，PRT 与 BCVA 之间也无相关性（所有 p 值均>0.05）。术后一周内 1mm（p<0.001）、3mm（p=0.013）和 6mm（p=0.034）区域的 PRT 下降与 CRT 增加相关（449.9µm-462.2µm）。
尽管光感受器层受到 ERM 的形态影响，并且在手术切除后也受到影响，但它与 BCVA 无关。因此，由于 ERM 导致光感受器层改变的患者仍可能受益于手术，并在此后获得良好的功能康复。
